Asthma in Toddlers

Detecting asthma in toddlers can be tricky. Learn how to identify the symptoms — and find out what you can do about them — so that you and your child can breathe easy.

Perhaps it’s your toddler’s persistent cough that first catches your attention. Or a whistling sound that you hear in her breathing. Or maybe it’s the way her colds always tend to linger. Could all these symptoms mean your wheezing wee one has asthma?

What is asthma?

Asthma is a condition in which a person’s breathing tubes (called bronchial airways) occasionally become inflamed, swollen and filled with mucus, often in response to an allergen or other irritation to the airways. Asthma flare-ups can cause shortness of breath, tightness in the chest, coughing and/or wheezing — and when it happens to your toddler, it can be downright frightening for both of you. After all, what’s scarier than watching your child not being able to catch her breath?

Why do some kids get asthma?

Asthma is the most common chronic disease in children. Why do some kids develop the condition while others don’t? Researchers believe it has to do with a child’s genes and/or environment. In other words, certain hereditary and environmental risk factors can predispose a child to developing asthma. These risk factors include:

A family history of asthma or allergies

Having eczema or other allergic conditions

Living with a smoker

Exposure to smoke in the womb

Living in an urban, polluted area

Low birth weight

Obesity

What causes an asthma flare-up?

There are several factors that can trigger asthma in toddlers, but what causes an asthma flare-up in one person may be different from what causes a flare-up in someone else. The most common asthma triggers are:

Allergens such as dust, pollen and pet dander

Irritants such as secondhand cigarette smoke, pollution and paint fumes

How is the disease diagnosed?

It’s often not easy to diagnose asthma in toddlers, because lung-function tests (in which a child blows into a machine that measures how quickly and how much air she can exhale) aren’t accurate in children younger than 6. That means the doctor will rely a lot on what you can share about your child’s symptoms. So take careful notes about what your toddler’s asthma symptoms are, how often they happen and under what conditions — and bring these notes with you to your appointment. The doctor will also ask you about your family’s medical history (do you or your partner have asthma or other allergic conditions?) to try to determine if your toddler is genetically predisposed to developing asthma.

How is asthma in toddlers treated?

For kids younger than 3, some doctors will suggest holding off on asthma medication for as long as possible (i.e., until asthma symptoms get worse). That’s because asthma medications are powerful, and experts aren’t sure about the long-term effects they may have on young children. If, however, your toddler has severe flare-ups and it looks like she would really benefit from them (and those benefits outweigh any potential risks), the doc may prescribe medication to see if your child’s symptoms improve.

Depending on the nature of your child’s asthma, the doctor might prescribe one or both of these types of medications:

A quick-relief (short-acting) medication called a bronchodilator that quickly opens up your child’s airways when they are swelling during an asthma attack.

A preventive (long-acting) medication, like an anti-inflammatory corticosteroid, which your toddler would need to take daily to keep the airways from getting inflamed in the first place.

Unlike other medications that come in a liquid form, which kids can swallow, most asthma medications need to be inhaled so they're delivered directly into your toddler’s airways. Older children and adults can use an inhaler to do this (an inhaler is a handheld device that contains the medication; you put the inhaler’s mouthpiece to your mouth, breath in, and the inhaler releases the medication, usually in the form of a mist). Since inhalers can be difficult for toddlers to use, you’ll probably need to put a little mask over your tot’s mouth and nose that will be attached to the inhaler or a nebulizer (which performs the same function as an inhaler but is bigger and isn’t as easily portable). The mask will make it easier for her to breath in the medicine correctly.

Whether or not your toddler gets medication, it’s also crucial that you do your best to help her steer clear of allergens or irritants that cause her asthma to flare up. That may involve keeping the house clean and dust-free or making sure your child doesn’t have playdates at homes where there are cats. It will take some extra planning, but your efforts will go a long way toward helping your child.

And there may be hope on the horizon: Many kids with asthma outgrow the condition by the time they hit adolescence, likely because their airways get bigger. So continue to check in with your child’s doctor regularly and keep tabs on your tot’s symptoms. That way you can stay on top of any changes (good or bad) in her condition.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect the Second Year. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.